Pain Disability Improvements Endure 7 Years After Bariatric Surgery

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Source/Disclosures Posted by: Disclosures: The authors report no relevant financial disclosures.

ADD SUBJECT TO EMAIL NOTIFICATIONS Receive an email when new articles are published Enter your email address to receive an email when new articles are published on . ” data-action=subscribe> Subscribe We were unable to process your request. Please try again later. If you continue to experience this problem, please contact [email protected] Back to Healio According to research published in JAMA Network Open, two-thirds of patients who underwent Roux-en-Y gastric bypass and sleeve gastrectomy experienced clinically significant improvements in pain and physical function 7 years after surgery. “Previous studies have shown that bariatric surgery is associated with improvements in pain, physical function and work productivity. However, most previous studies only followed participants for 1 to 2 years, when participants were at the peak of their weight loss,” Wendy C. King, PhD, associate professor of epidemiology at the University of Pittsburgh, told Healio. “Among a large group of US adults, we wanted to assess how much the initial improvements in pain, physical function, and work productivity declined during long-term follow-up, when some degree of weight regain is not unusual.” Source: Adobe Stock. King and colleagues limited their study to adults who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), the two most common bariatric surgeries performed today, according to King. They analyzed 1,491 patients (80% women) with severe obesity (BMI ≥ 35) undergoing bariatric surgery for the first time and participating in the multicenter Longitudinal Assessment for Bariatric Surgery-2 (LABS-2) cohort study. Researchers assessed preoperative to postoperative clinically meaningful improvements (CII) in bodily and specific pain, physical function, and work productivity among participants, focusing on changes between 3 and 7 years postoperatively and beyond. They used the 36-item Short Form Health Survey and the Western Ontario McMaster Osteoarthritis Index as well as a 400m walk time. According to the results, the preoperative median age of the participants was 47 years and the preoperative BMI was 47. The researchers further reported that 43% of patients had a mobility deficit, 42% had symptoms suggestive of knee osteoarthritis, and 32% had symptoms indicative of osteoarthritis of the hip. From 3 to 7 years after surgery, the proportion of participants with CII in pain decreased from 50% (95% CI, 48-53) to 43% (95% CI, 40-46), in physical function from 75% (95% CI, 73-77) to 64% (95% CI, 61-68) and in 400-meter walk time from 61% (95% CI, 56-65) to 50% (95% CI, 45-55 ). The researchers also reported that although absenteeism or work loss due to health initially decreased after surgery, it increased at year 3 and at year 7 was no better than before surgery. Presenteeism, or reduced work due to health, increased at 3 to 7 years after surgery, but remained lower than preoperative values. Wendy C. King “Decreases in pre- and post-operative improvements during follow-up were relatively small. As a result, clinically significant improvements in body and specific pain and physical function were common 7 years after undergoing RYGB or SG,” King added. “In addition, the presentation of work has decreased. These results are particularly striking considering the cohort was aged 7 years at follow-up, so many of them were in age groups in which declines in these measures are common.” Among patients with a preoperative mobility deficit, remission decreased from 50% (95% CI, 42-57) to 41% (95% CI, 32-49), according to the results. This reduction was also evident in patients with severe pain or disability affecting the hip (77% [95% CI, 72-82] at 65% [95% CI, 58-72]) or knee (77% [95% CI, 73-82] at 72% [95% CI, 67-77]). “Although this study provides strong evidence for the beneficial effects of RYGB and SG on pain and physical function, it also shows that not all patients maintain clinically significant improvements over long-term follow-up,” King concluded. “Some postoperative patients likely experience levels of pain and disability that affect their quality of life and prevent them from adopting or maintaining an active lifestyle, especially as the time since surgery increases. “Thus, there is a need to test and identify effective interventions for postoperative patients who need additional interventions to improve pain and physical function outcomes.”